The basic concepts of resistance in Gram negative bacteria

In Step 2.2 you were introduced to the danger that antimicrobial resistance, especially among Gram negative bacteria, poses for clinical treatment globally.

Since their introduction, cephalosporins, beta-lactam/beta-lactamase inhibitor combinations and carbapenems have been the standard of care for the treatment of infections due to Gram-negative bacteria.

Because of their importance, a basic understanding of the concepts frequently used to address the problem of resistant Gram-negative bacteria is necessary.

In the table below you will find a summary of these key concepts. You should familiarise yourself with these before moving on.

As we have learned, antimicrobial resistance can be acquired by different routes. Expression of beta-lactamases – enzymes capable of rendering beta-lactam antibiotics ineffective – is one of the most important mechanisms of resistance among Gram-negative bacteria.